Specialist recommendation.

Specialist initiation only and RICaD

First choice. BSSE APC preferred agent. This recommendation must only be taken into account after a patient and prescriber have discussed all treatment options (including warfarin) and only if they have no preference about which medicine they want to use. To be initiated by those who have the appropriate skills and experience.

Use should be in line with local commissioning arrangements - for BCC CCG - Anticoagulation AQP. Ensure that patients prescribed anticoagulants receive appropriate verbal and written information at the start of therapy, at hospital discharge, on the first anticoagulant clinic appointment, and when necessary throughout the course of their treatment (NPSA Alert 18)

Specialist ophthalmologist recommendation

Short term use only

Unlicensed special

Tablets, orodispersible tablets and nasal spray

APC verdict - present status = RED (Future status = AMBER with a framework in primary care before transfer - commissioning discussion)  

Specialist initiation only, ESCA